When I was recently approached by officials from the CPhA to participate in this year’s conference in Fredericton NB, I was frankly surprised; I have often been critical of the CPhA, and I have questioned its relevance in the face of today’s seemingly overwhelming pharmacy challenges. I have also been generally sceptical of the value of the many endless conferences that pharmacy seems to hold (the Ontario Pharmacists’ Association Conference followed immediately on the heels of this CPhA national conference). Admittedly, I had not been to a conference in many decades.
Nevertheless, I agreed and I took part in ‘The Great Debate’ re the viability of pharmacist prescribing, or expanded scope of practice (ESP). My position was to act as ‘antagonist’ meaning I was to be against this initiative to expand pharmacists’ role in the healthcare system.
This premise was difficult to defend, and I indicated at the outset that I was indeed NOT against pharmacist describing or ESP. As I have indicated in my previous two blogs, I believe ESP is critical and timely in the face of three realities:
- Automation which is rapidly overtaking many functions which are data based, repetitive in nature and subject to algorithmic applications
- The ‘corporatization’ of pharmacy as a profession by non-pharmacist owned & controlled Big Pharmacy Retail (BPR)
- Plunging drug prices, which are inherently good for patients, but bad for pharmacy under present pharmacist compensation structures.
It’s not the rationale, or the justification, or the clear & urgent need that are the problem; it’s whether the pharmacy landscape, as it exists today, is conducive to the professional development of pharmacists’ patient skills. And I still maintain that the landscape is not fertile for this kind of development; I wish it was.
While the profession of pharmacy is under the control of non-pharmacist retailers, and pharmacists are essentially unrepresented retail employees of BPR, these kinds of initiatives will remain successful largely ‘in vitro’, and will fail the test of time ‘in vivo’.
Of course the young, enthusiastic, passionate delegates at the CPhA conference would have none of this, and more power to them!
I would not have wanted to throw cold water on their vitality or their optimism for the world. I admire them all greatly, and I truly hope they achieve their life goals and enjoy outstanding successful careers and total professional fulfilment.
And this is the big lesson I learned from the conference. No matter how dark the present situation may appear, the vitality & passion of youth can overcome many obstacles. These traits can lead to the achievement of the dreams this new cohort of pharmacists seeks to turn into reality. I will be first in line to boost them on.
My only parting words of caution and advice are these. In order for a tree to flourish and grow, it must be planted in fertile ground. Do not make the mistake of believing you can achieve your goals if you plant yourself in the wrong environment. I know this will be tough, especially in markets where BPR totally dominates the landscape/marketplace. Find or create your own environment and then do what you were educated to do, and do it with passion.
Choose the wrong environment, and it will take less than six months before your spirit is broken. Search out your predecessors and find out how they feel after a year in the BPR trenches. Don’t rely on my warning alone.
You have so much to offer. Put it all to good use where it can flourish and make a difference. This is your obligation and your destiny if you take control of it now.